Editors Note: Serge medical missionaries are showing the love of Jesus through hands-on medical care in some of the remote locations on Earth. In this post, Kacie Forrest, RN, serving in Bundibugyo, Uganda, reflects on how to respond in the face of overwhelming need.
At work last week, the charge nurse found me in the labor ward and asked me to come with her. She seemed excited that I was there.
As I followed her through the dark hallway into the small-windowed nurse’s room, I wondered, “What could it be that she wanted only me to do?”
“Miss Kacie, I am very happy to see you today!” she smiled. “How are your children? And your husband?”
Then from behind her back, she pulled about six patient charts, and I instantly knew what it was. The same thing I did last week at the beginning of the shift, and the week before.
Discharges.
I was instantly disappointed.
“We need to clear the patients off the floor because we need some beds to open up. Can you please work on these so the women can go home?”
“Sure,” I said.
I grabbed the first chart and took a deep breath. Just get through these quickly, then you can move on to the real work.
What this “real work” was, I’m not really sure. Just something that wasn’t paperwork.
Paperwork is the worst.
The charge nurse thanked me as she left. Through the window I saw family members already lining up to ask her questions, students who needed her expertise, patients holding their babies whom they wanted her to look at.
Of course, I can discharge these patients, I thought, seeing how busy she already was.
So I started, looking through each chart, finding numbers that matched the equivalent number in the registry. Filling out dates, and names of towns, and whether the patient had a c-section or a spontaneous vaginal delivery. Double-checking their medications particularly for HIV + mothers and babies, and writing in the counseling everyone is supposed to have on breastfeeding and home care before leaving the hospital.
I could hear a rat in the cabinet above me, squirming his way through a small hole in the wall. I changed my seat so I was facing the cabinet, rather than my back to it.
I continued with the work.
After about an hour of doing this, thoughts began playing through my mind.
Did I just turn into the ‘discharge paperwork girl’?
Am I losing my critical thinking skills doing this work?
Did I move half-way across the world to checkboxes?
Then the thoughts turned on me.
If I always say I can help out with this, is this all I will ever do?
There are high-risk patients in the labor ward right now, is anyone even in there assessing them? (Not a bad question to be asking.)
I’m here to teach, this isn’t teaching!
Am I just getting used, do I need better boundaries?
And finally, the thought that pushed me out of my seat:
I can’t be doing this work right now, there are more important things for me to do!
When the books kept coming in and the discharges seemed like they would never end, I stood up and told the charge nurse I needed to go to the maternity ward to check on the mother who had had three seizures since she’d arrived.
I was really struggling internally. It’s not usually my move to just abandon someone like that. But I did.
Learning to Lay Down My Life
Later that week I brought this scenario up to my team leader during a monthly review meeting.
I wanted her thoughts on everything because I respect her, she has decades of experience, I need guidance in these areas, and I had left that situation conflicted with a gross feeling.
She listened and told me point blank if the charge nurse wants me to be doing discharges, I should be doing discharges. She listed her reasons for this, which all made sense.
I still had to ask,
“What if I’m doing this the entire time I’m here? I’ve got resources to share that are more valuable than doing paperwork! Isn’t that just a waste?”
She assured me that it most likely wouldn’t play out that way – I wouldn’t be spending two years behind a desk – and affirmed that yes, boundaries are essential. But if I’m asked to do a seemingly menial task for a small portion of my shift that benefits the ward, I shouldn’t say no.
Then she listed off a few ways that her skillset is also not best utilized as a doctor on the pediatric ward. Ways that she easily is doing something that is not glamorous, someone less skilled could easily do, but needs to be done.
She said, “It’s not a waste. It’s servant leadership.”
The words ‘servant leadership’ startled me a little, because servant leadership is Christ-like, which is the direction I want my life pointed in.
But I could see that my heart and my actions in the nurse’s ward were not that.
I walked home and found some alone time that afternoon, to get quiet, write, and pray. Who better to ask questions about serving than to Jesus?
In my journal, I wrote out two questions:
Generally speaking, can servant leadership tends to look like a waste of good resources to most people?
From a human perspective, is it a nonsensical strategy?
I imagined writing our monthly update letter to our friends and family, where I would share “I filled out paperwork at the hospital this month!” Would people wonder if their resources were being wasted by having me here? As a missionary, you are not somewhere on your own. You carry with you the loved ones who have sent you.
Which is another reason why I needed to be in my house, on the ground, asking God for greater clarity.
Ultimately, we are here because of how He has led us, and this journey is supposed to make us and those we come in contact with, more aware of and more like Christ, not less.
This means I should be more concerned about how He wants me to live, and less concerned about outcomes, appearances, having interesting medical experiences, or not appearing strategically foolish.
Responding to Overwhelming Need
One of the first things that came to my mind as I wrote was the simple fact that I am working in an extremely under-resourced place in the world. Which means there are so many demands and not enough hands.
Not having enough doctors, nurses, supplies, blood, water, electricity, pens, paper, IVs, beds, masks, blood pressure cuffs, personal protective equipment, etc., etc. is a challenge.
Imagine it this way: You go to your favorite place to eat fast food.
Now imagine a line out the door and around the block (you’re in the front of the line, congrats). Every table is full in the dining room. People are spilling drinks everywhere. The bathrooms are out of toilet paper and the toilets are clogged. There is no running water. Only half the lights are working in the entire building.
Picture the grill in the kitchen working at half capacity, but somehow the cook has adapted and is not complaining. You had planned to order a hamburger but just found out there hasn’t been ketchup or buns available for days. So, you change your order to a grilled cheese wrapped in lettuce.
The only other person working beside the cook has been taking orders in both the drive-through and inside and somehow meal tickets are scattered all over the floor, in no particular order. This man has been working here for 8 years and is managing to stay sane. His uniform is even crisp and white. He greets you with a smile and asks how you are doing. You notice behind his shoulder, underneath a shelf, there is a rat gnawing on a piece of cheese.
A random person walks to the back to talk with the chef, who is sweating and busy cooking up patties. The person wants to work here and has noticed how detrimental the rodents are to the environment of the restaurant. They are a health risk and are ruining the inventory. This person wants to teach them how to rid their business of rats.
I’ll pause there.
This may seem like a severe picture I’ve painted, but it is a fairly equivocal example of the conditions of much of the hospital here and I’m thinking it may paint a better picture than explaining it another way.
I came here with the idea to teach Helping Babies Breathe, which I have been doing and is important. But in a resource-thirsty place, you do what needs to be done at the moment, with whatever you have available, just to stay afloat.
Teaching and learning have their place and when there is a slow moment (which there are) I jump on my opportunity.
But I am not the cook in this scenario. I am not the person who has worked here 8 years, with the steadfastness and the knowledge of how to best serve people and get through the days. I see the monumental obstacles everyone is facing, and I have been called to be here in those.
So what must I do amidst this?
I need to do what the team needs me to do.
I must practice how to work in a Christ-like way, by loving others at a cost to myself. In this scenario, it means doing discharge paperwork.
And that – is holy work.
The challenge is to have the vision to see it that way.
My team leader told me, “People will notice.” Because it strikes a different chord when someone chooses the road of self-sacrifice.
Not as a way to gain attention, but I imagine it as a way to show a very real side of God’s heart to people.
I cringed a little knowing the opposite. That when I left the remaining discharges to go to the maternity ward, that also left an impression. But this spiritual walk is all about asking God to make us more like Him. It’s called sanctification, and I am a work in progress!
Now, I can see an opportunity for me to try something new next week. I don’t plan on miraculously loving paperwork, but I am asking God to change my heart. I want to enter into my coworker’s struggles as if they are my own, and to see past my own agenda and respond with humility.
I want this in other areas of my life too, not just work.
In this time of COVID, and the intense and validated tensions around racial inequality, I think these are transferable aspirations. To enter into people’s struggles as if they were our own, to see past our own agendas, and in turn to respond with humility.
This is the work of the Spirit… not by our own accord.
Holy Spirit come!
This post was originally posted on Kacie Forrest’s blog, shared here with permission.
